Document Detail


Training rapid stepping responses in an individual with stroke.
MedLine Citation:
PMID:  21511992     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Compensatory stepping reactions are important responses to prevent a fall following a postural perturbation. People with hemiparesis following a stroke show delayed initiation and execution of stepping reactions and often are found to be unable to initiate these steps with the more-affected limb. This case report describes a targeted training program involving repeated postural perturbations to improve control of compensatory stepping in an individual with stroke.
CASE DESCRIPTION: Compensatory stepping reactions of a 68-year-old man were examined 52 days after left hemorrhagic stroke. He required assistance to prevent a fall in all trials administered during his initial examination because he showed weight-bearing asymmetry (with more weight borne on the more-affected right side), was unable to initiate stepping with the right leg (despite blocking of the left leg in some trials), and demonstrated delayed response times. The patient completed 6 perturbation training sessions (30-60 minutes per session) that aimed to improve preperturbation weight-bearing symmetry, to encourage stepping with the right limb, and to reduce step initiation and completion times.
OUTCOMES: Improved efficacy of compensatory stepping reactions with training and reduced reliance on assistance to prevent falling were observed. Improvements were noted in perturbation asymmetry and step timing. Blocking the left foot was effective in encouraging stepping with the more-affected right foot.
DISCUSSION: This case report demonstrates potential short-term adaptations in compensatory stepping reactions following perturbation training in an individual with stroke. Future work should investigate the links between improved compensatory step characteristics and fall risk in this vulnerable population.
Authors:
Avril Mansfield; Elizabeth L Inness; Janice Komar; Louis Biasin; Karen Brunton; Bimal Lakhani; William E McIlroy
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-21
Journal Detail:
Title:  Physical therapy     Volume:  91     ISSN:  1538-6724     ISO Abbreviation:  Phys Ther     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-02     Completed Date:  2011-08-11     Revised Date:  2011-12-21    
Medline Journal Info:
Nlm Unique ID:  0022623     Medline TA:  Phys Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  958-69     Citation Subset:  AIM; IM    
Affiliation:
Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. avril.mansfield@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Accidental Falls / prevention & control
Adaptation, Physiological
Aged
Cognition Disorders / epidemiology
Comorbidity
Humans
Male
Movement / physiology*
Physical Therapy Modalities*
Postural Balance*
Reaction Time
Stroke / epidemiology,  rehabilitation*
Task Performance and Analysis
Weight-Bearing
Grant Support
ID/Acronym/Agency:
//Canadian Institutes of Health Research

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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